Successful Complete Laparoscopic Resection of Benign Peritoneal Multicystic Mesothelioma Adherent to the Ascending...

Benign peritoneal multicystic mesothelioma (BPMM) is a rare mesothelial tumor with a high local recurrence rate and potential for malignant transformation. It predominantly affects women of reproductive age and is often associated with prior abdominal surgery or inflammation. Complete surgical resection is the standard treatment; however, tumor recurrence remains a concern. BPMM occurring outside the pelvis is extremely rare, and lesions requiring colectomy because of adherence to the gastrointestinal tract are infrequent.

A 63-year-old woman presented with right lower abdominal pain. She had undergone cervical cancer surgery 20 years ago. Contrast-enhanced CT and MRI revealed multiple well-defined cystic lesions adjacent to the ascending colon. Colonoscopy revealed extrinsic compression, and ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG)-PET/CT showed no abnormal uptake of ¹⁸F-FDG. Given the patient's symptoms, a laparoscopic right hemicolectomy with intracorporeal anastomosis was performed. The cystic lesions were firmly adhered to the appendix, cecum, and ascending colon, requiring en bloc resection. Histopathological and immunohistochemical analyses confirmed a diagnosis of BPMM. The patient had an uneventful postoperative course and was discharged on POD 7. No recurrence was observed during the 1-year follow-up period.

A laparoscopic approach may be a feasible and safe option for complete resection of BPMM as it allows for magnified visualization and careful handling of cystic lesions, avoiding their intraoperative rupture. Given the high recurrence rate of BPMM, close postoperative surveillance is essential. This case illustrates the feasibility of laparoscopic resection for BPMM.